Workplace Safety and PPE

Nurses COVID

Published

Specializes in Emergency Room.

The CDC current recommendations for mask use/re-use:

-Discard N95 respirators following use during aerosol generating procedures.

-Discard N95 respirators contaminated with blood, respiratory or nasal secretions, or other bodily fluids from patients.

-Discard N95 respirators following close contact with, or exit from, the care area of any patient co-infected with an infectious disease requiring contact precautions.

https://www.CDC.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html

The WHO recommendation for surgical mask use/extended use:

-Surgical Mask extended use no more than 2-6 hours.

-N 95- no more than 5 uses before discarding (also CDC/NIOSH)

https://www.cebm.net/covid-19/extended-use-or-re-use-of-single-use-surgical-masks-and-filtering-facepiece-respirators-a-rapid-evidence-review

My facility policy on use/re-use:

We wear surgical masks all day. We wear surgical mask and face shielding all patient contacts.

We are given one surgical mask to use for the entire 12 hour shift.

We are given one N95 mask per shift that really only gets discarded if seriously soiled. We don and doff into a plastic storage container. We reuse it after five days of rest for an unspecified amount of uses. We use N95 or PAPR with shield for suspect or confirmed Covid patients.

We also have a limited amount of PAPR units to use but have to de-contaminate the "disposable" face piece to share among other staff.

Per Dr Osterholm, The University of Minnesota's Director of the Center for Infectious Disease Research and Policy:

"People want to wear a mask. That's great. But I think we're going to show in the end that many more health care workers were infected by working with only surgical masks and not N95 [masks]. I realize and understand the shortage of N95. I get that [surgical masks] are better than nothing, but I don't think that it offers anywhere near the protection that we need for this virus."

https://www.MSN.com/en-us/health/medical/Dr-osterholm-questions-covid-19-guidelines-on-cloth-masks/ar-BB13GGRP

I have given this a ton of thought due to being high-risk, as well as having a son and husband at home that are also high-risk. I am trying to take my own surgical masks so that I can swap out after a few hours. I am also tying them so that they fit more tightly. I am using the N95 once, and then switching to the PAPR. ( I cannot confidently say that I can don/doff the duckbill style N95 without it somehow contaminating myself). I am considering purchasing my own PAPR hood, but am not sure if my facility will allow it. It feels overkill, but I just feel like there are too many healthcare provides getting this darn virus at work. Overkill? Probably, but this madness is just too much for my already anxious brain to handle....

4
Up Vote Up Vote ×

Hahaha!! The CDC doesn't live in reality, it's obvious! I can't discard my K95 that easily! (we don't have N95s) I could probably get a new mask every week or so. I ended up buying my own K95s but they're so expensive!!

The CDC need to help facilities get the proper PPE. Although I'm not even sure my facility wants to invest in extra PPE.

Up Vote Up Vote ×
9 hours ago, MeganMN said:

The CDC current recommendations for mask use/re-use:

-Discard N95 respirators following use during aerosol generating procedures.

-Discard N95 respirators contaminated with blood, respiratory or nasal secretions, or other bodily fluids from patients.

-Discard N95 respirators following close contact with, or exit from, the care area of any patient co-infected with an infectious disease requiring contact precautions.

https://www.CDC.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html

The WHO recommendation for surgical mask use/extended use:

-Surgical Mask extended use no more than 2-6 hours.

-N 95- no more than 5 uses before discarding (also CDC/NIOSH)

https://www.cebm.net/covid-19/extended-use-or-re-use-of-single-use-surgical-masks-and-filtering-facepiece-respirators-a-rapid-evidence-review

My facility policy on use/re-use:

We wear surgical masks all day. We wear surgical mask and face shielding all patient contacts.

We are given one surgical mask to use for the entire 12 hour shift.

We are given one N95 mask per shift that really only gets discarded if seriously soiled. We don and doff into a plastic storage container. We reuse it after five days of rest for an unspecified amount of uses. We use N95 or PAPR with shield for suspect or confirmed Covid patients.

We also have a limited amount of PAPR units to use but have to de-contaminate the "disposable" face piece to share among other staff.

Per Dr Osterholm, The University of Minnesota's Director of the Center for Infectious Disease Research and Policy:

"People want to wear a mask. That's great. But I think we're going to show in the end that many more health care workers were infected by working with only surgical masks and not N95 [masks]. I realize and understand the shortage of N95. I get that [surgical masks] are better than nothing, but I don't think that it offers anywhere near the protection that we need for this virus."

https://www.MSN.com/en-us/health/medical/Dr-osterholm-questions-covid-19-guidelines-on-cloth-masks/ar-BB13GGRP

I have given this a ton of thought due to being high-risk, as well as having a son and husband at home that are also high-risk. I am trying to take my own surgical masks so that I can swap out after a few hours. I am also tying them so that they fit more tightly. I am using the N95 once, and then switching to the PAPR. ( I cannot confidently say that I can don/doff the duckbill style N95 without it somehow contaminating myself). I am considering purchasing my own PAPR hood, but am not sure if my facility will allow it. It feels overkill, but I just feel like there are too many healthcare provides getting this darn virus at work. Overkill? Probably, but this madness is just too much for my already anxious brain to handle....

I wasn't laughing at your post , btw. Just laughing at their "recommendations". I appreciate your post and the topic, it needs to be discussed.

I have just given up on hoping my facility will be anywhere near compliant with CDC.

I'm sorry if you took my post the wrong way.

x

1
Up Vote Up Vote ×
Specializes in Emergency Room.

@NewRN'16 oh goodness, no offense taken!! I am interested in hearing opinions, so even if it is different than mine, no worries. I totally agree with you! I just have to come to terms with how I am going to deal with my particular facility and protocols. I am not sure. I just read this and am chewing on it.

https://mikerowe.com/2020/07/im-not-ignoring-covid/

1
Up Vote Up Vote ×
Specializes in Private Duty Pediatrics.
1 hour ago, NewRN'16 said:

Hahaha!! The CDC doesn't live in reality, it's obvious! I can't discard my K95 that easily! (we don't have N95s) I could probably get a new mask every week or so. I ended up buying my own K95s but they're so expensive!!

The CDC need to help facilities get the proper PPE. Although I'm not even sure my facility wants to invest in extra PPE.

I buy my own, too.

2
Up Vote Up Vote ×
Specializes in Emergency Room.

@Kitiger and others. What I am wondering, is how to deal with surgical mask vs N95 mask for all day use? I float around the facility constantly, helping in the ED, ICU, etc., And wear a surgical mask. I would almost feel better with an N95 but am not sure if that is overkill. Are other ED nurses out there wearing an N 95 with every patient? Or are you wearing surgical masks for non-Covid suzpect? I would definitely have to buy my own, which would be expensive. Right now I just do not know... Trying to come to terms with my reality, but it is not an easy thing...

1
Up Vote Up Vote ×
17 minutes ago, MeganMN said:

@NewRN'16 oh goodness, no offense taken!! I am interested in hearing opinions, so even if it is different than mine, no worries. I totally agree with you! I just have to come to terms with how I am going to deal with my particular facility and protocols. I am not sure. I just read this and am chewing on it.

https://mikerowe.com/2020/07/im-not-ignoring-covid/

Glad you're not upset.

I don't know how to deal with the situation either. ?

1
Up Vote Up Vote ×
8 minutes ago, MeganMN said:

@Kitiger and others. What I am wondering, is how to deal with surgical mask vs N95 mask for all day use? I float around the facility constantly, helping in the ED, ICU, etc., And wear a surgical mask. I would almost feel better with an N95 but am not sure if that is overkill. Are other ED nurses out there wearing an N 95 with every patient? Or are you wearing surgical masks for non-Covid suzpect? I would definitely have to buy my own, which would be expensive. Right now I just do not know... Trying to come to terms with my reality, but it is not an easy thing...

K95s are better than surgical masks. Try to find those. I also wear a surgical mask on top of the K95 . I change the surgical masks quite often.

On edit: I buy my K95s at $5 a mask at my local gas station. Online they are much more expensive, but I found this treasure mom&pop gas station they have K95 galore.:)

1
Up Vote Up Vote ×
Specializes in Personal protection.

Why don’t they have N95s? In my unit we received N95s and are getting more next week. New delivery every week. Please let me know if you need a contact.

Up Vote Up Vote ×
Specializes in Emergency Room.

@Kevin UPP I have no idea why. We just got a huge shipment of new 3M masks and got re-fit tested. they still want us to follow the same re-use policy and have no maximum number of uses. It makes no sense. Money, maybe. Who knows.

Up Vote Up Vote ×
Specializes in Long term care.

I work in LTC. We are one of the hardest hit facilities in our county. Never once have I worn or seen any other caregiver wear ANYTHING other than a KN 95 mask & face shield and gown/gloves when giving care to a person positive for the virus. What's more unnerving is that we removed the gown, shield & gloves, placed them at the door for reuse (x 5 days). Leaving the mask on and continue on to the next patient who may or may not have the virus. We wear THE SAME MASK for 5 shifts in a row....be it 8 or 12 hour shifts. A nurse dates each mask before giving it to us. We continue to have people test positive.

I am pretty sure they mistranslated the guidelines for PPE during this pandemic.....which is less "safe" than what we were doing for contact precautions pre covid 19.

I question why I risk my health & that of my family. I did get sick at the very beginning & it really frightened me & my family. A coworker lost her husband who likely got it from her when she brought it home.

I am currently looking for another job along with most of my coworkers who haven't left already. I just can't do this again when the virus hits hard again this Fall.

2
Up Vote Up Vote ×
+ Add a Comment